Does an Inflammatory Pattern at Primary Biopsy Suggest a Lower Risk for Prostate Cancer at Repeated Saturation Prostate Biopsy

Pepe, Pietro; Aragona, Francesco

doi:10.1159/000328043

Cited by 15 publications

(7 citation statements)

References 47 publications

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“…Although the causes of prostate inflammation are to the best of our knowledge poorly understood, acute and chronic inflammatory infiltrates are frequently observed in prostate biopsies. Previous studies have indicated that between 35% to 100% of prostate biopsies performed for concern about PCa had some histological evidence of inflammation . The variability in prevalence is likely due to the fact that inflammation is not routinely evaluated or reported by pathologists.…”

Section: Discussionmentioning

confidence: 99%

Baseline prostate inflammation is associated with a reduced risk of prostate cancer in men undergoing repeat prostate biopsy: Results from the REDUCE study

Moreira

Nickel

Gerber

et al. 2013

Cancer

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BACKGROUND The current study was performed to evaluate whether baseline acute and chronic prostate inflammation among men with an initial negative biopsy for prostate cancer (PCa) increased the risk of subsequent PCa detection in a clinical trial with systematic biopsies. METHODS A retrospective analysis was performed of 6238 men aged 50 years to 75 years with prostate‐specific antigen levels between 2.5 ng/mL and 10 ng/mL and a prior negative biopsy in the REduction by DUtasteride of PCa Events study who completed a 2‐year biopsy. PCa, acute prostate inflammation, and chronic prostate inflammation were assessed by central review. The association between inflammation in baseline prostate biopsies and positive 2‐year and 4‐year repeat biopsies was evaluated with the chi‐square test and logistic regression analysis adjusting for baseline covariates. RESULTS Acute and chronic inflammation and both were detected in 46 baseline biopsies (1%), 3931 baseline biopsies (63%), and 892 baseline biopsies (14%), respectively. Acute and chronic inflammation were found to be significantly associated with each other (P < .001). Acute inflammation at baseline biopsy was associated with younger age, lower prostate‐specific antigen levels, and a smaller prostate (all P < .01), whereas chronic inflammation was associated with older age and larger prostate glands (all P < 0.01). At the 2‐year biopsy, the prevalence of PCa was 14% (N = 900 patients). On univariable and multivariable analysis, both acute and chronic inflammation were found to be significantly associated with a lower PCa risk (acute univariable: odds ratio [OR], 0.65 [P < .001] and multivariable: OR, 0.75 [P = .012] and chronic univariable: OR, 0.61 [P < .001] and multivariable: OR, 0.65 [P < .001]). At the time of 4‐year biopsy, only acute inflammation was found to be associated with a lower PCa risk. CONCLUSIONS Baseline acute and chronic inflammation were both found to be independently associated with a lower PCa risk. From a clinical standpoint, inflammation in negative biopsies for PCa may lower the risk of subsequent PCa detection. Cancer 2014;120:190–196. © 2013 American Cancer Society.

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Section: Discussionmentioning

confidence: 99%

Baseline prostate inflammation is associated with a reduced risk of prostate cancer in men undergoing repeat prostate biopsy: Results from the REDUCE study

Moreira

Nickel

Gerber

et al. 2013

Cancer

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“…An inflammatory pattern at primary biopsy is not associated with a decrease in prostate cancer incidence at repeated saturation prostate biopsy; therefore, only an accurate clinical evaluation including more parameters (i.e. urinary PCA3) could hopefully select men who need to undergo rebiopsy in the presence of persistent suspicion of cancer [15]. Evaluation of the preventive effect of finasteride on chronic bacterial prostatitis in Wistar rats suggest the possibility that finasteride has a preventive effect on development of chronic bacterial prostatitis, although there is as yet no consensus on the mechanism of this effect [16].…”

Section: Discussionmentioning

confidence: 99%

Acute Bacterial Prostatitis in Humans: Current Microbiological Spectrum, Sensitivity to Antibiotics and Clinical Findings

Nagy

Kubej²

2012

Urol Int

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Objective: To assess the current microbiological profile and sensitivity to antibiotics in patients with acute bacterial prostatitis (ABP). Patients and Methods: In the period 2003–2010, we treated 192 ABP patients, aged from 18 to 85 years (average 56.3 years). We performed a biochemical examination including a microbiological urine examination. After admission, we immediately began the empirical antibacterial treatment. Results: The clinical picture was dominated by pain, prostate enlargement and failure of micturition in 185 (96.4%) patients; 14 (7.3%) patients had acute urinary retention where epicystostomy was necessary. Fever occurred in 177 (92.2%) patients and Escherichia coli was the most frequent etiological agent detected in 103 (53.7%) patients followed by Pseudomonas aeruginosa and Klebsiella species. In 16 (8.3%) patients we found 2 bacteriological strains. Sterile urine was found in 65 (33.8%) patients. Fluoroquinolones, aminoglycosides and cephalosporins were used most frequently. 147 (76.6%) patients were treated according to the microbiological results. Overview of resistance shows an increase in resistance to fluoroquinolones. In 14 (7.3%) patients there was progression to urosepsis. Conclusion: Clinicians should consider local drug-resistance patterns when choosing antibiotics and should adjust the therapy on the basis of bacterial cultures and local sensitivity to antibiotics.

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“…Previous studies indicate that between 35% and 100% of prostate biopsies done for suspected prostate cancer had some histologic evidence of inflammation (12)(13)(14)(15). However, factors associated with inflammatory changes in the prostate of men undergoing biopsy are largely unknown.…”

Section: Introductionmentioning

confidence: 99%

Smoking Is Associated with Acute and Chronic Prostatic Inflammation: Results from the REDUCE Study

Moreira

Nickel

Gerber

et al. 2015

Cancer Prevention Research

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Both anti-and proinflammatory effects of cigarette smoking have been described. As prostate inflammation is common, we hypothesized smoking could contribute to prostate inflammation. Thus, we evaluated the association of smoking status with acute and chronic inflammation within the prostate of men undergoing prostate biopsy. We retrospectively analyzed 8,190 men ages 50 to 75 years with PSA levels between 2.5 and 10 ng/mL enrolled in the Reduction by Dutasteride of Prostate Cancer Events study. Smoking status was self-defined as never, former, or current. Prostate inflammation was assessed by systematic central review blinded to smoking status. The association of smoking with inflammation in the baseline, 2-year, and 4-year biopsies was evaluated with univariable and multivariable logistic regressions. At study enrollment, 1,233 (15%), 3,203 (39%), and 3,754 (46%) men were current, former, and never smokers, respectively. Current smokers were significantly younger and had smaller prostates than former and never smokers (all P < 0.05). Former smokers were significantly heavier than current and never smokers (P < 0.001). Acute and chronic prostate inflammations were identified in 1,261 (15%) and 6,352 (78%) baseline biopsies, respectively. In univariable analysis, current smokers were more likely to have acute inflammation than former (OR, 1.35; P, 0.001) and never smokers (OR, 1.36; P, 0.001). The results were unchanged at 2-and 4-year biopsies. In contrast, current smoking was linked with chronic inflammation in the baseline biopsy, but not at 2-and 4-year biopsies. In conclusion, among men undergoing prostate biopsy, current smoking was independently associated with acute and possibly chronic prostate inflammations. Cancer Prev Res; 8(4); 312-7. Ó2015 AACR.

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Does an Inflammatory Pattern at Primary Biopsy Suggest a Lower Risk for Prostate Cancer at Repeated Saturation Prostate Biopsy

Cited by 15 publications

References 47 publications

Baseline prostate inflammation is associated with a reduced risk of prostate cancer in men undergoing repeat prostate biopsy: Results from the REDUCE study

Baseline prostate inflammation is associated with a reduced risk of prostate cancer in men undergoing repeat prostate biopsy: Results from the REDUCE study

Acute Bacterial Prostatitis in Humans: Current Microbiological Spectrum, Sensitivity to Antibiotics and Clinical Findings

Smoking Is Associated with Acute and Chronic Prostatic Inflammation: Results from the REDUCE Study

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